MEDICARE: ANGIE L GOESER PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	11824	NE

General Provider Information

NPI Number	:	1598828618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGIE L GOESER PHARMD

Provider Business Mailing Address
First Line	:	7917 KANSAS AVE
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-2135
Country	:	US
Telephone Number	:	402-740-0704
Fax Number	:

Provider Business Practice Location Address
First Line	:	7909 N 30TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68112-2418
Country	:	US
Telephone Number	:	402-280-3992
Fax Number	:	402-280-4785

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	07/08/2007

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